STANDARDS FOR EXCELLENCE
Self-Study Application Package & Checklist
© 2002-2012 Pennsylvania Association of Nonprofit Organizations (PANO)
The application package and checklist for PANO’s Standards for Excellence® Voluntary Certification Program consists of this form and attachments that the organization will supply and label according to these instructions. The Standards for Excellence staff may request additional documentation of information for clarification purposes.
To apply for the Standards for Excellence Voluntary Certification Program, please complete this application and return it with full payment (see fee schedule) or balance, if registration fee was previously paid, to:
Pennsylvania Association of Nonprofit Organizations (PANO)
777 East Park Drive, Suite 300
Harrisburg, PA 17111
Please review the entire Standards for Excellence: An Ethics and Accountability Code for the Nonprofit Sector® Application/Self-Study packet thoroughly before beginning the application process. For questions or concerns, please contact Tish Mogan at PANO, 717-236-8584 Ext. 1011 or email at .
Date of Application:
Name of organization:
Is the organization known by other names or acronyms?
Address:
Phone: Fax: Website address:
Number of paid staff (please provide the approximate number of full time equivalents):
Number of volunteers (not including board members):
Number of board members (independent of staff):
Total expenditures (last fiscal year completed):
Organization's fiscal year runs from: to
Date of Incorporation:
Individual primarily responsible for assembling this application package and checklist:
______________________________________ _______________________ _____________________
Name Phone Email address
Certification Statement:
We certify that the information provided in this Standards for Excellence® Self-Study Application Package and Checklist is true and correct, policies outlined are followed and all licenses, permits, insurance and governmental approval necessary for operations have been obtained.
Chair of Board CEO or Other
Signature Signature
Print name Print name
Title Title
Phone Phone
Applications will remain open up to one year from the date of submission. After one year has passed, the organization will be asked to submit an additional fee of $500 to keep the application active for an additional year. Applicants may also choose to withdraw their application and re-apply at a later date.
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The Pennsylvania Association of Nonprofit Organizations (PANO) encourages organizations to contact the association staff for assistance in implementing the policies and practices described in the Standards. Training programs and extensive written educational materials are available. Our intent is that every applicant will ultimately be successful in achieving compliance with the Standards for Excellence.
Self-Study Application Instructions
1. Read the Standards for Excellence: An Ethics Code for the Nonprofit Sector®.
2. Organizations must submit an initial “Registration for Certification” document. Organizations will then receive the Self-Starter Application Kit. Organizations must complete one of the following required training options: Guiding Principles Webinar Series (6 1.5-hour online sessions), Standards for Excellence Implementation Workshop (1-day in-person session) or some form of One-on-One training on certification to ensure appropriate understanding of the criteria.
3. Read and complete the Self-Study Application Package and Checklist and assemble requested documents.
4. Send 1 copy (see below for instructions electronic submission) of the completed Self Study Application Package and Checklist , the requested attachments and application fee (if not already paid) to the Pennsylvania Association of Nonprofit Organizations.
5. Please enclose the application fee payable to PANO (less the $200 Registration fee if applicable).
PANO Member Fee Rates Option A Option B
Full Yearly Fee Following Yearly Fee Following
Application Initial Certification Recertification
Annual Operating Budget Fee (three-year rate) (five-year rate)
Up to $500,000 $1,700 $ 595 $ 355
$500,001-$1,000,000 $2,400 $ 840 $ 505
$1,000,001-$2,500,000 $3,000 $1,050 $ 630
$2,500,001-$5,000,000 $3,500 $1,225 $ 735
$5,000,001 - $10,000,000 $4,100 $1,435 $ 860
$10,000,001 - $15,000,000 $4,700 $1,645 $ 985
$15,000,001 - $20,000,000 $5,500 $1,925 $1,155
Over $20,000,000 $6,300 $2,205 $1,325
Nonmember Fee Rate
All nonmember organizations: $7,000
6. Following the staff review (Phase 1) of the Self-Study Application, staff may request additional materials. Forward one set of materials to PANO and add materials to the other Self-Study Applications. Mail three copies to the PANO office for the Peer Review (Phase 2) review. (One copy of the application is kept with the organization)
● We recommend that organizations interested in participating in this program appoint a Standards for Excellence committee or task force made up of board members and key staff to work together in assembling this comprehensive self-study application. Please see the codes in parenthesis following each question in the application for a reference to the relevant portion of the Standards for Excellence: An Ethics and Accountability Code for the Nonprofit Sector.
● Applicants are invited to use the Self-Study Applications and the accompanying documents to illustrate the organization's implementation of the 55 Standards. If one or more of the Standards is not appropriate for the organization, please write "n/a" in the space provided on the Self-Study Application Package Checklist and provide a detailed explanation of the special circumstances that preclude the applicant from implementing the Standard. In some cases, a special written waiver request will be required.
· Applicants may choose to submit their electronic application on CDs or flash drives, in PDF format. Please see below for instructions.
Electronic Submission
For the Phase I review, please provide one copy on a writable CD (CD RW) or flash drive. Please provide an index of the documents. Use folders to divide the application in eight sections corresponding to the Guiding Principles along with a ninth section for disclosure. Attachments should be coded with numbers provided in these instructions (i.e., I-a, I-b, I-c… etc.). Please ask for the copy of more detailed electronic submission directions.
● If the answers to a particular question can be found elsewhere in the application, create and label a separate document. Include a short sentence explaining where it is located on the CD or flash drive.
● If a particular Standard is not applicable to your organization, please explain why the Standard is not applicable and include this explanation in a separate labeled document.
● For questions which request a narrative answer, please keep responses to one page or less (with the exception of the program evaluation section that may require longer responses).
● To speed the Self-Study Application and peer review process, carefully check to be sure that all attachments are enclosed. See last page of Self-Study Application package for a complete list of requested attachments.
● Applicants should keep a copy of the completed application and accompanying materials for future reference.
● Upon completion of the Phase I review, submit three additional copies of the documentation.
Self-Study Application Review Process
Staff Review (Phase I)
Once a Self-Study Application Package is received by the Pennsylvania Association of Nonprofit Organizations, Standards staff will conduct an initial review of the materials. At that point, staff will contact the applicant organization if additional information or clarification is needed via phone, letter and/or in-person consultation.
Peer Review (Phase II)
Completed Self-Study Application Packages will be forwarded to a team of trained peer reviewers. The team will thoroughly review the Self-Study Application Package and make a recommendation to the Standards Committee. At this time, Standards staff may request an in-person consultation to discuss clarification or additional information needed as a result of the peer review team meeting. A site visit will take place to provide a clear sense of operations and services rendered.
A site visit will take place upon completion of the Peer Review.
Standards Committee Review
The Standards Committee makes the final decision regarding an organization's Self-Study Application. Applicants may request reconsideration by the Standards Committee if not satisfied with the initial decision. A formal appeal process is also available.
● Every effort will be made to avoid conflicts of interest in the peer review process. Peer reviewers will be required to disclose their interests and organizational involvement in a disclosure form. Applicants will be given the opportunity to identify peer reviewers who may have a conflict of interest.
● Staff, peer reviewers, and Standards Committee members will adhere to a strict confidentiality policy that safeguards the confidentiality of all aspects of the Self-Study Application submitted and the applicant organization. The identity of peer reviewers evaluating specific Self-Study Applications will remain anonymous to the public and applicant organizations.
Standards for Excellence Program
● Materials submitted will not be subject to public inspection and will be viewed only by PANO Standards staff and individuals involved in the peer review process, unless permission is granted by the applicant organization to allow others to view documents.
● Only organizations that have successfully completed the peer review process will be publicly announced.
● The Standards for Excellence Seal will be awarded for three years based on licensing guidelines governing the seal. In the years between certification and recertification, Seal holders may be required to respond to annual requests for updated information and documentation.
This Self-Study Application requests many different policies and written descriptions of organizational procedures and practices. Some policies requested must be approved by the board of directors. For board-approved policies, the date of board approval is generally requested. Other policies requested may be management or operational policies. For these policies, applicants should note that policies have been implemented or enacted in the organization and provide documentation.
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I. Mission and Program
A. Mission
I-a Attach the organization's written mission statement. (Standard IA1)
● When did the board of directors most recently review the organization's mission statement?
/ / (Standard IB1)
● Please provide meeting minutes if available; otherwise, provide narrative explaining when and how this took place.
The Standards state that this review should occur every 3-5 years.
B. Organizational evaluation
I-b Describe the organization's current activities, indicating how activities are consistent with the organization's mission statement. (Standard IA1)
C. Program Evaluation
I-c Attach a list of the organization's programs. Indicate the percentage of total organizational effort that is expended on each program listed. (Organizational effort is defined by the organization itself based on any combination of time, funds and/or other resources.) (Standard IC1, IC2)
Note to applicant: Please provide a brief description of how you defined organizational effort.
I-d Describe how each of the organization's programs is evaluated. For each program, specifically address:
● What information is collected (qualitative and quantitative).
● How your program evaluation approach addresses cost of services in relation to outcomes (programmatic efficiency).
● How you evaluate outcomes for program participants (programmatic effectiveness).
● How the evaluation methods used (1) involve program participants, (2) are cost effective and (3) are appropriate for your organization.
● How your evaluation system is used to strengthen and improve your organization. In other words, describe the feedback loop your organization has in place for using evaluation to measure progress toward achieving your mission. (Standard IC1, IC2)
● The board’s involvement in the evaluation process.
Applicants are encouraged to attach any evaluation tools (reports, questionnaires, templates) that provide further evidence of the organization's program evaluation efforts. (Please use discretion with the number of pages submitted.) (Standard IC1, IC2)
D. Program Service
I-e For organizations serving individuals and/or families, attach a copy of the organization's policies regarding program participants and treatment of participants' confidential information. If the organization does not serve individuals and/or families, describe how you treat constituents confidentiality. (Standard ID1)
I-f Describe how the organization measures the satisfaction of program participants. (Standard ID1)
I-g Attach a copy of the organization's grievance/problem solving procedure to address complaints from program participants. Include a description of how program participants are made aware of the grievance procedure. (Standard ID1)
II. governing Body
A. Board Responsibilities
II-a Attach copies of board minutes from the last 12 months. Please be sure that your submission includes board minutes from a full fiscal year. You may need to provide board minutes for a period longer than a calendar year in order to include a full fiscal year. (Standard IIC6)
Indicate date and page of board minutes reflecting the following:
● Board's resolution indicating that the organization will apply for the PANO Seal of Excellence. / / Page _____
● Board’s approval of the organization's most recent budget. / / Page _____ (Standard IIA3)
● Board's most recent annual review of the percent of expenditures spent on program, administration and fundraising. (Many organizations conduct this review while discussing the organization's annual Form 990 or budget.) / / Page _____ (Standard IIA3)
● Board’s approval of the organization’s most recent audit (if the organization has annual revenue in excess of $500,000). / / Page _____ (Standards IIA3)
● Board's most recent evaluation of the executive director. / / Page _____
(Standard IIA4)
● Board's most recent approval of executive director's compensation package. / /______ Page _____ (Standard IIA4)
● Who is responsible for the board minutes? (Standard IIC5)
● Where are the board minutes kept? (Standard IIC5)
YES NO Has the board delegated decision making authority to a committee in any specific subject areas? If so, what areas? ____________________________________
II-b Attach copies of committee minutes for committees: executive, finance, audit and other committees which have been delegated decision making authority by the board in areas that otherwise would be a board responsibility (for the last 12 months). (Standards IIA, IIC)
YES NO Are decisions made by committees with decision making authority reported to the full board? (Standard IIC6)
II-c Explain how the board of directors engages in long term and short term planning activities. If available, include copies of any documents illustrating board planning efforts (e.g., strategic plan for organization, board work plan, etc.). (Standard IIA1)
II-d Attach the organization's most recently approved budget. (Standard IIA3)
II-e Please indicate date (year) current executive director was hired. (Standard IIA4) Enclose a copy of the executive director’s contract (if one exists) and description of the executive director’s compensation package.
● If the board hired an executive director in the last three years, describe the process.
II-f Provide the organization’s compensation structure. Describe how the board reviews the organization's overall compensation structure (i.e., assessing staff compensation):
(1) Vertically – comparing the lowest paid to the highest paid;
(2) Horizontally – comparing similar positions in the organization and industry. For key positions provide a description of how the board has gathered data to determine comparability with fair market value for similar positions;